HomeMy WebLinkAboutR 2019-160 AMS - BIRS PFAP roof repair DocuSign Envelope ID:A5F66F6C-3B2C-40FB-98B6-C183C558465E
ORANGE COUNTY—DEPARTMENT USE ONLY
Party/Vendor Name: SIRS, Inc Party/Vendor Contact Person: Mike McClure Contact Phone: 336-574-3060
Party/Vendor Address: PO Box 36197 City Greensboro State:NC Zip: 27416 'Department: AMS Amount: $967.50
Purpose:PFAP Roof Budget Code(s): 10240320-570000 Vendor ft 57369 (NIA if new vendor) Vendor is a BOCC
consultant? Yes ❑No[] Contract Type:(Check one)New❑ Renewal ❑ Amendment ❑ Effective Date 2126/19
Approved by Board Yes❑No❑ Agenda Date:
This agreement is approved as to technical farm and content and I as Department Director affirmatively state work on
this project has not been initiated prior to execution of the agreement:
DocuSigned by:
QW. PbOoJA,
Department Director's Signature 21EFs7aAr_D454EF.. Date:3/6/2019
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Agreements for emergency services or repair are not subject to the above affirmation. If services related to this
agreement have already begun or been completed please briefly describe the nature of the emergency condition that was
addressed: Emergency roof leak repair for Piedmont Food and Ag Center.
Information Technologies
(Applicable only to har•dwarelsoftware purchases or related services)This agreement has been reviewed and is
approved as to information technology content and specifications:
Office of the Chief Information Officer Date:
Risk Management
This agreement is approved for sufficiency of' Qocusigned by: ' pecifications,and requirements:
Q
Office of the Risk Management Officer USA c6m&6 7FDCF0176800408. Date; 3/7/2019
Financial Services
This instrument has been pre-audited in the ma Docusigned by: T tl Government Budget and Fiscal Control Act:
Office of the Chief Financial Officer Date:3/11/2019
7D4E51S1ACC1409.
Legal Services
This agreement is approved as to legal fo DocuSigned by:
I
3/11/2019
Office of the County Attorney EAasossEDaaaa 5.. Date.-
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Sherri Ingersoll upon completion: singersoll@orangecountync.gov
The following signature block is for hard copies only and is not required for Docusign contracts:
Office of the Clerk to the Board Date:
Revised 12118 4